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Sergey Young & Dr David Perlmutter On Why Uric Acid is the Unknown Underlying Driver of Many Diseases, What Fructose is Doing to Us, What We Can Do About It And much more.

the Longevity & Lifestyle Podcast

Today’s guest is Dr. Richard Johnson, where we will take a deep dive into the role of dehydration in metabolic diseases and aging, the impact of high sugar and high salt intake in cognitive decline, and tips on preventing weight gain. | Brought to you by InsideTracker. More on InsideTracker and special offer below!

Dr. Richard Johnson is a professor of medicine at the University of Colorado and is a clinician, educator, and researcher. He is board certified in internal medicine, infectious diseases, and kidney disease and is the founding editor of Comprehensive Clinical Nephrology, one of the main textbooks on kidney disease. For more than 20 years, he has led research on the cause of obesity and diabetes, with special interest in the role of sugar (especially fructose) and uric acid. His research has been highly cited, published in top medical journals, and supported by grants from the National Institutes of Health. He is the author of The Sugar Fix and The Fat Switch. Dr. Johnson lives in Colorado with his wife, kids, and two rambunctious puppies.

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“My goal is not to make money. My goal is to help people. That's why I became a doctor.” - Dr. Richard Johnson

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Dr Richard Johnson

Episode 62

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“If you are dehydrated, or if you have a high vasopressin level, that it increases your risk to become fat. And not only is it associated with being overweight, but it also predicts, whether or not you , can, will gain weight.”

“And then, there's a lot of people in Japan who eat a lot of salt, soy sauce and things like that. And so it's been known that in Japan, there's a lot of, so sodium intake and, we found that, that salt intake in Japan, that the people with higher salt intake were at increased risk for developing, obesity, fatty liver diabetes.”

“...we should be drinking enough to have about three liters of urine a day.”

“My general recommendation is that, six to eight glasses of water a day. Probably is, excellent. And I recommend drinking a glass of water before each meal. Because, that will help keep the serum salt down because if you drink water before you eat salt, that's gonna be better than eating the salt first, activating the switch and then trying to reverse it. “

“If you're in a bar and there's alcohol and, salted chips and pretzels, and you feel like you're going to eat a little bit, drink a glass of water during that time. Yeah. That will help with the alcohol. It will help with the salt.”

“All these foods get injected with salt, and what they do is they inject meats and stuff and it makes the meat look [00:28:00] bigger. Like a shrimp looks really bigger because it's been pumped with salt water.And then, the truth is that it's actually much smaller. And when you put it on the frying panel, all the water comes out”

“There's some studies showing that fruit dose in the brain can cause the insulin resistance, the mitochondrial problems, and even affect memory of animals.”

“My goal is not to make money. My goal is to help people. That's why I became a doctor and, so if we can find ways to block this switch, it would be a great thing for mankind, or humankind.”

“Try not to eat a lot of salty foods. And it, and if you can reduce your salt intake, that would be a positive thing.”


Claudia von Boeselager: Dr. Richard Johnson, Rick. So wonderful to have you back onto the longevity and lifestyle podcast. Thank you so much for coming back for round two.

Dr. Richard Johnson: Thank you, Claudia. Really I'm happy to be back.

Claudia von Boeselager: Thank you. So last time we were discussing uric acid and your amazing discovery in this space and metabolic conditions that are. Push or that, that arise out of high uric acid levels today. I'd like to start with a different angle and talk about dehydration and how it has so many implications also on different diseases that we know.
Can you talk a bit more about that?

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Dr. Richard Johnson: Absolutely. So as from our last, meeting, we talked about the fact that, there seems to be a biologic switch. [00:02:00] That, animals use to, to, protect them from times when there's no food. And one of the things, when there's no food, there's often no water.

And so a lot of animals when they hibernate or when they nest they're living off their fat, but the fat can also be a source of water. . And so what happens is these animals. Like a hibernating bear will, will not be drinking water during the hibernation. Rather they will be getting their water when they break down the fat and the fat doesn't contain water.

 But when they, when you burn fat, you produce water. And surprisingly fat is not, is really another source of water. So it turns out that there are a lot of animals that use fat as a source of water. When water's not available like whales, even though they live in the sea they, don't drink, salt water at all.

And so they get most of their water from food, but they also get some water from [00:03:00] the fat. They have maybe one third of their water comes from the fat that they carry. And so fat becomes important as a source of water. And so this made us wonder if mild dehydration. might be, stimulus to, to activate the switch, because if you were just mildly dehydrated, you'd wanna try to, to store fat to help you in case you things get worse.

And so we started thinking about that. And one of the first things we did was we looked at people who are overweight and actually there were a lot of studies that were already out there. and surprising many people who are overweight or obese tend to be dehydrated and there's this one study, there's this, wonderful scientist, Dr.

Jody Stuckey. And she has, made her career looking at hydration status of people. And she has, really made the case that people are under hydrated, that they're not drinking enough [00:04:00] water. And one of her findings was that people who are overweight or obese. Tend to be much more dehydrated than people who are not.
And, that people who are obese, using this one test called a bio impedance, which is this kind of fancy testing. They can show that a, , if you're obese you're 12 times more likely to be dehydrate. So the, it is really, it's really quite striking and, and there's a hormone associated with dehydration.

 That's produced when people are dehydrated and it's called vasopressin. And, and that it, the way that hormone works is that it stimulates the kidneys to hold into water. So it makes your urine really, concentrated and, dark yellow and Fure and smell that. And that's because it's taking all the water out and saving it for you and reabsorbing it in your body so that, when you're out walking in a very [00:05:00] hot environment, Your urine will become concentrated because your body's trying to hold into water.

 And so this hormone vasopressin has been observed to be high in people who are obese and, this Association's been known for about 10 years and no one really understood it that well, but vasopressin, is really high in people with obesity. It's high in people with diabetes, it's high in people with metabolic syndrome.
And, and this finding along with the fact that, most people are overweight, , has been known. And interestingly, there are now studies. That's showing that if you are dehydrated, or if you have a high vasopressin level, that it increases your risk to become fat. And not only is it associated with being overweight, but it also predicts, whether or not you , can, will gain weight.

And so there's actually interest [00:06:00] in measuring this as a blood test, as a diagnostic to look at your risk for developing obesity and Metabo syndrome. And the test is called co Pepin but it is really a measurement of vasopressin. So there's. association of dehydration with, with obesity and there, as I bet you, you have a bottle of water right next to you.
Do you or maybe now sorry.

Claudia von Boeselager: No, of course I have tea with fresh lemon is oh, yes.
Dr. Richard Johnson: Yeah.

Claudia von Boeselager: That's wonderful. I probably over hydrate. But tell me what your, yeah, so I like the green tea also for focus
Dr. Richard Johnson: and oh yeah. Green. Tea's wonderful.

Claudia von Boeselager: Actually. And the fresh lemon as well, not only for vitamin C, but, to get me going.
 Yeah, so I literally have, this is one liter, and I probably drink between three and five liters a day,

Dr. Richard Johnson: so yeah. Oh, just wonderful. So the, so here's, what's, when you know, I'm a physician and I work at the hospital and I see patients and. And I'm a kidney [00:07:00] doctor and there's this classic teaching that, you know, that the kidneys do the work for you.

And if you get dehydrated, they're gonna concentrate the urine and hold on to water. And this, idea that people should be running around drinking a bottle of water, every. Hour or two, is considered to be silly by a lot of physicians and, like a myth, oh yeah. Yeah.

There's this theory that drinking a lot of water, can, help prevent obesity, but what's the evidence. What's the evidence. And I've heard this a lot. But, what's not well known is that people who are dehydrated, are at risk for obesity and people who are overweight and obese tend to be dehydrated so one of, one of the really, so we did a whole bunch of research to try to figure this out, does what's the dehydrate?
Yeah. Is it just a correlation or is it. And is there a real causal relationship? Okay. So one of the first things we did was we started thinking about it and we realized that dehydration, although animals, when they get [00:08:00] dehydrated, usually we think of it as losing.

 Like an animal that has diarrhea or sweating a lot or vomiting where you lose water and what happens is, the salt concentrations in your blood go up because there's less water there. And that's would be like a true type of dehydration. You actually lose water and that stimulates thirst, and then we go and drink water.
 But it's, deep being dehydrated, it's not really a comfortable situation. We don't like to lose water , but you could become mildly dehydrated by and, without losing water. And we realized that's what happens when an animal eats salt. so when you like a, you eat salt or a deer finds a salt lick and licks the salt it's salt concentration goes up in the blood , but it's not losing water.

It's just gaining salt. And then what happens, and this was, has been [00:09:00] shown, is that, what happens when a, when that happens is you get thirsty, you drink water . And so it's like a way to bring water into the body. And, and what happens. So we thought to ourselves, could that be a mechanism to drive fat?
And we, as you, as we talked about last time, we think that fruit dose is the driving nutrient that causes obesity. And we think the way most of us get it is from eating sugar. And eating high fruit dose, corn syrup and the, these added sugars contain fruit dose. And they're present in 70% of the processed foods.

And, we're eating like 15% of all our food is from sugar. So it is a major source. Yeah. But what we found is that, the body can make fruit dose. And the body can make fructose from glucose. So you have to have glucose around, to make [00:10:00] fructose. And so we found out that high glycemic carbs get converted, like rice and bread, they're BA basically starch.

And when you eat starch, the glucose goes up in the blood and that triggers the production of fr dose. And recently there was just a study published, showing that, people who are eating. Carbs like this, that you can generate as much as, a fruit dose in a day as, as is present in a soft drink.

So that's a fair amount of fruit dose. Yeah. And so you can produce fruit dose from carbs. But interestingly, the way that reaction occurs where glucose gets converted to fructose, it's a chemical reaction. And the enzyme that makes that chemical reaction is stimulated by high salt concentrations.

It's like its favorite the most. The easiest way to activate this enzyme is to eat salt. And so we go, oh my God. So if people are eating salt, which, we have a taste for salt, we like [00:11:00] salt and and if this activates this enzyme, then it will convert the carbs.

Into, fruit dose, even, high glycemic car do it on their own, but even, other carbs, just if you have glucose on board, the salt is going to activate this enzyme. So for the French fries, which have salt and, often or they're salted, that would, yeah, that would turn those potatoes into sugar in your body.

 Wow. So we started looking at this and we go, gosh, there's, so I called my friends who are obesity doctors, and also my friends who are high blood pressure doctors, and one of them who is, Georgetown. said to me, wow. We all know that people who are overweight are eating high, salt diets.

 Every time you measure the urine salt and the, the urinary salt is super high, they're all in high salt diets, I thought, wow. And then I, we started looking at it and yes, salt intake [00:12:00] correlates with, stimulating causing dehydration, raising vasopressin, and it predicts obesity.

in fact, there was a study done, about 20 years ago where people put, were put on a high salt diet and they became insulin resistant in five days just by increasing the salt of the diet. Really? Yeah. Unbelievable. Yeah, maybe it was, it might have been seven days I'm but it was like a week. It was like a week nice.

Five to seven days. They were like insulin resistant. That's pretty striking. And then, there's a lot of people in Japan who eat a lot of salt, soy sauce and things like that. And so it's been known that in Japan, there's a lot of, so sodium intake and, we found that, that salt intake in Japan, that the people with higher salt intake were at increased risk for developing, obesity, fatty liver diabetes, and that it was, you could separate it from calorie intake.

and one of the, [00:13:00] so one of the things is the salt, activates the switch, but of course you have to have carbs present because the glucose is converted to fructose . So it also told me that if you're on a low carb diet salt, probably wouldn't increase your risk for obesity, cuz you don't have enough carbs around to convert it.
 And likewise, if you're dehydrated in a setting where you're dehydrated and you don't. Food. You're not gonna be storing fat. You're gonna be breaking down fat because, because you're not activating the switch to make fat. You don't have the glucose around, you need to break down the fat.

 So I, that would make sense to me. So we said to ourselves, okay, if this is real, then if I feed salt to a mouse, it should get fat and, there were these papers out that said that if you give salt to a mouse, they start eating more. And there's even data in people that if you give salt to people that they start eating more

But, but no one had [00:14:00] really shown if it causes obesity. So my friend Miguel and I, we said, let's do it, let's do it. So we put these little mice on salt and got it excited. And, when you put them on sugar, they get fat within a month or two they're really fat. It takes a month or so before they really start gaining weight, even six weeks with a, it isn't immediate , but, but they do get fat, but with salt, we went and we, they started eating right away.

We could show that they were, that they were eating more, but they seemed to be burning more too initially. , and, they really weren't gaining weight for the first month . And I said to, Miguel, I said, maybe our thinking's wrong. Maybe it's not the case. The second month came by.

They, so we're pretty skinny, but they were like really hungry and I go, ah, what's going on. But, and suddenly right around the third month they started like gaining weight, and then very rapidly. And before long, they were like huge. They were big and they were, diabetic and fatty liver.

And. And it was [00:15:00] pretty amazing. And when we looked in their livers, they had a ton of that they were making, even though they weren't eating  And, and then we did the same experiment in a group of animals that could not, burn fructose. , they could not metabolize  and they were, they stayed skinny, even though they ate the same amount of salt.

So with, at that point, we really knew that, that there was another cause of obesity. It isn't just sugar. It's also salt that these, that it's was there to be a way to help animals protect themselves. , by providing the, , water for when they need it. And, and that, this is why the camel has the hump and, and all this stuff.
So it was pretty, it was a pretty cool story. And, . Yeah. So then, we said to ourselves, okay, so if this is the case, how does it relate to the vasopressin? And I have always liked this hormone vasopressin, and it's like this hormone that, [00:16:00] people don't totally understand it.

 Because, it binds to different receptors, right? One of the receptors is the one in the kidney that causes the kidney to hold onto water. So that's called the V2 receptor. And, but there's a, are these V one receptors that no one really knows what they do. And in, when you're a doctor, if you're doing research.

 If there's, something that no one knows about gets you excited, say, what does those, what is the function of those receptors? And it, there was some data that it was associated with, like stimulating, glucose production and things like that. But no one really had a function for it in people

And I was able to. Get mice that, had been genetically engineered. So they don't have the V one, a receptor, the V one B receptor in my, we had a young fellow, Tom Jensen who started running these experiments where he was giving, salt and sugar and so forth to these animals. And one of the [00:17:00] first things we found out is that, that, all those salt, obviously stimulated, vaso, press.

it stimulated fructose as well as we talked about. So salt was stimulating, both fructose production , but it was also stimulating vasopressin. But the two were linked because when we blocked the fructose metabolism, we blocked the vasopressin production. So it was, they, the two were linked and, and then when we, what we found is that, that when we gave sugar to animals, if we gave high fructose corn syrup, their vasopressin levels went up to and around the same time.
A group in, Cleveland, gave, soft drinks to people and found that, that raised vasopressin. So now we know that people who are overweight have high vasopressin levels and, they can, and the vasopressin associated both with, dehydration, with sugar, salt intake, and with sugar intake.

And so they're all kind. they're together. And again, we don't [00:18:00] know causality. So what Tom did was we gave the sugar to animals that did not have these vasopressin receptors and low and behold, if we gave it to one with the V one, a receptor where it was blocked, they actually got fatter. They loved the fructose and they got fatter.

But if we gave the fructose to one that missed, didn't have the V one B receptor suddenly they were totally protected. They didn't get fat at all. They were lean, they, and they loved sugar. So they were eating all this sugar, but they weren't getting fat. And, they had turned off the switch.
 Even though, the, we, the switch was basically turned off of these guys. So we know now that vasopressin is involved in the switch, along with uric acid and that it's working through a particular receptor. And, and we've now expanded it there's a hormone.

 Actually this is like the first hormone that drives obesity. Leptin protects [00:19:00] against obesity. But this is a hormone that drives obesity and it's working through a particular receptor. And it was pretty cool at discovery. And so it, then when we said, okay, if we can hydrate an animal, can we reproduce what people are doing when they're drinking water?

and so we gave sugar to animals and we increased their water intake and the way we did that was be because they were taking the sugar in their drinking water. We had to give the water a different way. So we gave, we made the child, the food and

the little pallets they were eating. We hydrated those pallets so that the gels were, the food was a little.

Bigger cuz it contained water and they actually loved that food and they ate the same amount or even, they ate the same amount of total chow and but they got extra water. And when they got that, we could block, obesity and we could even reverse it partially.

 We could slow waking for sure on sugar, [00:20:00] but we could reverse the insulin resistance. And there was some real benefit. so this, I feel this is one of the, luckiest things that we stumbled on and, that's great. Yeah. So suddenly I know that this myth, when all these, young doctors who are all very athletic and skinny and they come running around with their bottles of water, it's real.

And I. Who unfortunately was not a great water have tried to drink more and I, and the data shows that theoretically, we should be drinking enough to have about three liters of urine a day . So the normal urine outputs, like one liter a day, or maybe one and a half liter a day.

 But if you can get your balance up so that you're urinating like two and a half or three liters a day, you should have a real. Positive effect. And you don't wanna go, much more than that. Because that's, you can drink too much water and then you can dilute your serum sodium. And that might not be good [00:21:00] because it can cause headaches and even seizures, if you, so it's possible to become water.
I toxic.

Claudia von Boeselager: what are levels from a practical point of view, Rick? Because I don't know how many people will actually go about, I think meeting if you go to the other side of the spectrum.

Dr. Richard Johnson: Yeah. I, my, my general recommendation is that, six to eight glasses of water a day. Probably is, excellent.

 And I recommend drinking a glass of water before each meal. Because, that will help keep the serum salt down because if you drink water before you eat salt, that's gonna be better than eating the salt first, activating the switch and then trying to reverse it. Yeah. So yeah,

Claudia von Boeselager: drinking.
Yeah. Sorry,

Dr. Richard Johnson: go ahead. Yeah. So if you get a. What I've been doing now, it's, takes a little bit of CU, CU getting accustomed to it is I begin by asking for a glass of water and then my personal [00:22:00] role is not to eat a bite of food until I drink a full glass of water and then I started eating and then I, maybe I have a second.
And I try to get six to eight glasses of water in a day. Try not to drink right before I go to bed because I don't want to get up. Yeah. And, and I think that's a very good balance. Like six to eight, eight ounce glasses a day is perfect. Now there are three situations. I'm a doctor.

Okay. There's three situations where you don't wanna drink a lot of water without talking to your personal physician. The first one is if you undergo surgery, especially if you're a woman and especially if it's gynecologic surgery, there's, some people will get a syndrome with a hold onto water really significantly in that first 24, 48 hours after surgery.

 And drinking a lot of water at that time can be life's threatening, cuz you can hold onto the water and. get swelling in your brain and so don't drink [00:23:00] a lot of water following surgery, just in general. The second one is if you have heart failure or some really big problem with your heart, and you're holding onto fluid, you may not want to drink a lot of water without talking to your doctor.

Sometimes it's good, but oftentimes it's not. So you have to talk to them. And then the third one, which is relevant. all the athletes in the audience is that marathon running can be associated with holding onto water. It's a rare thing that there have been deaths in the Boston marathon where people were drinking too much water and they drop their sodium and they season you can die.

Okay. And marathon runners, the rule is , drink to thirst. If you're thirsty. But don't over drink. I believe that the marathon runners hyponatremia as they call it may actually be related to, to drinking a lot of sugary beverages, during marathon runs [00:24:00] and, and I'm putting together a story to, to test that but, but anyway, at this point we don't know the.

But we do know that drinking a lot of water during the marathon is not, recommended. So you should drink to thirst. And when you're doing severe exercise, very, strenuous, endurance type exercise, be careful. So those otherwise. Drink drinking otherwise. Yeah. Drink eight glasses of water a day drink before you, before meals drink.

If if you're in a bar and there's alcohol and, salted chips and pretzels, and you feel like you're going to eat a little bit, drink a glass of water during that time. Yeah. That will help with the alcohol. It will help with the salt. And you don't wanna, you don't want to activate that switch.

Claudia von Boeselager: So useful. And I think also before bed is, really good as well to allow the body to detox and rehydrate night. I have a question around salt and is every type of salt, [00:25:00] an issue? No, where there's like layer salt that has minerals. There's, sea salt, there's different types of salt as well. Has your research looked at the different

Dr. Richard Johnson: types?
Yes. yes. And there's data in animals too. So sodium chloride I is, which is what we call table salt. Yeah. That is the one that activates this potassium, chloride, or sometimes, there's light salts. Where there's. They mix it with sodium and potassium, the potassium Chlor.

Salts do not activate this. Okay. Okay. But you can, you don't want to eat a lot of potassium salts if you've got kidney disease or something where you can hold onto potassium . But, unfortunately most of the things that we call salt, natural salts and so forth, contain sodium chloride, to, some extent.

 I'm not against salt and I'm not against sugar. I just think we need to be aware that they can activate the switch. And so I recommend for healthy living [00:26:00] to minimize eating a lot of sugar and to avoid sugary beverages. Really, it'll help. It'll help you a lot. Doesn't mean you can't have sh cake.

 The, your, on a birthday or things like that, just, but you just have to be aware that it activates a switch, same things with salt salty food is going to activate this switch. It's a slower activation that seems than with sugar, it takes longer. But I think that. you have to be careful.

And so try not to add salt to food, try to keep your salt and take down. If you are eating salty food, drink water, just drink water with it. You can neutralize it. And if you're on a low carb diet, you probably don't have to worry about salt. Because you don't, you're not eating the carbs that are required to, to convert the glucose to fructose.

 You should know that when you're in a low carb diet, your body is making glucose, you would call it glucose neogenesis. So glucose is in your [00:27:00] blood, but it's being made from muscle and fat and you're not producing a lot. It, but when you're eating carbs, you can eat a large amount of glucose. And so that, along with salt, is a, is a.

Claudia von Boeselager: that's really helpful to understand as well. But I think, yeah, the key is with that water consumption obviously barring those three scenarios, just to hydrate the body and to give it the right. And obviously then cutting down on salt and, again, I think, just that education around reading labels and oh yes.
Salt is actually in pretty much. Anything. And even in, I was looking once at a packet of chocolate chip cookies and not only the amount of sugar in there, but the amount of salt that they were putting in there to neutralize the sweetness. It was really

Dr. Richard Johnson: wow. Wow. That's really interesting.
 I have a friend who's, in the food industry and and, he's been, he started telling me about how. All these foods get injected with salt, and what they do is they inject meats and stuff and it makes the meat look [00:28:00] bigger. Like a shrimp looks really bigger because it's, been pumped with salt water.
And then, the truth is that the it's actually much smaller. And when you put it on the frying panel, all the water comes out, the salt stays and now you gotta, process. Look at, sometimes they'll tell you whether or not it's been injected with things and, salt water is a favorite thing to inject into these, shrimp and stuff.

Claudia von Boeselager: Oh my God, actually really interesting what you were saying because, literally a few weeks ago I was at my parents and I was making, some shrimp, but I tried to always wear possible find the wild caught shrimp. Now it was still in cell, but they don't shrink. In size. And I was thinking how astoundingly, what a difference.

And I'm very worried that a lot of the shrimp, even if it says, , you have to really read the label, but a lot of them are farmed, filled with antibiotics, et cetera. Yep. That must be the telltale sign. how much the shrimp, when you warm it up shrinks or not? Yes. , [00:29:00]

Dr. Richard Johnson: what's really going on it shrivels up in front of you.
Okay. Yeah. Process food, there's so many studies that show that if you can. Try to reduce your intake and process food, you can really help. And, it's cuz of the sugar and salt, high fructose corn syrup and all these things, MSG and stuff that's added.

Claudia von Boeselager: It's horrendous. Exactly. So I think,
with seafood, it's finding that wild caught seafood and then for meats, right?
The grass fed meat, as well, and you can taste the difference. And I think it's moving away from having to have a huge steak every night to actually seeing it as like a, an exception, like a nice pleasure a few times a week instead, and then other invest and buy the quality versus the quantity as well.

Dr. Richard Johnson: Yeah, a grass fed is really better than grain fed. And, I didn't really talk about this in my book. But it's really true with grass feeding. You get much more omega threes. And with the grain fed, you get more omega six and the meat and, there's really [00:30:00] increasing evidence. And I do talk about this in the book about how omega3s are so healthy.

and omega six tends to be pro-inflammatory. And these seed oils that are omega six, rich are not so good. And they interact with this fructose pathway. So if you give omega three, you can block some of the effects of sugar, especially on the brain. So if you give sugar fructose to an animal, you can actually show that it can impair their ability to get through a maze.

 And you can reverse that with omega3. Omega3 yeah. Walnut oil is, a flax seed and, fish, that are rich and omega3, salmon. That's good.

Claudia von Boeselager: They're really good for Rick. What would you say? And I'm just trying to hypothesize here, cause I know you are, also amongs other the research scientist in you, but I'm looking at like a ven diagram intersection of between salt and sodium chloride, specifically, fructose and all metabolic.
Or [00:31:00] many metabolic diseases. Would you almost say that combination is a major driver?

Dr. Richard Johnson: Oh, it's unbelievable. And so one of the, , strong associations initially was yes, sugar intake, salt intake, their associated with obesity, their associated with diabetes. The metabolic syndrome, fatty liver, this is where the, my research was, , kidney disease.

 And these kind of classic diseases then leading to heart disease and so forth. , but what, one of the two incredible, areas that we've started looking at is how the switch and the, can also be important in cancer and also how it's important in neurologic disease, especially dementia the cancer one is really interesting.
 And that is that. This switch reduces the production of energy in the body. So it acts to decrease the amount of ATP that's produced by.
Oh, [00:32:00] Rick.

Claudia von Boeselager: You froze.
 Interrupt you for whatever reason you froze there. So just after ATP. Okay. Yeah. If you could just recommend it, it just froze sure. Way. Thanks.

Dr. Richard Johnson: Yes. Yes. So there's two forms of energy. Really? That can be two ways. ATP can be produced. And one way is from the mitochondria. And they make most of the ATP.

It's a lot of it and, but they require oxygen. And then there's a primitive system called glycolysis. It's really an ancient system and it does not require oxygen, but it just makes a small amount and cancer cells like glycolysis because they're often in a low oxygen environ. Because when a cancer cell metastasizes, like from one side to another, it initially doesn't have a blood supply.

So it has to create a blood supply. So it lives in a low oxygen state. And so it turns out that cancer cells [00:33:00] prefer, energy that's produced by glycolysis because it doesn't require as much oxygen. So they actually often use glyco. And there's an actual name for it's called the Warburg effect.

And it was discovered, in the 1930s that cancer cells tend to live through the Warburg effect. The way the switch works is it tries to reduce, it tries to help an animal survive. And so one of the ways to help you survive is to reduce your oxygen. Because what if you're in a bur or someplace where there's not a lot of oxygen, so the switch can get turned on in a low oxygen state.

And what it does is it suppresses the ATP produced by the mitochondria. So it reduces the oxygen need. . And so there's an animal called the naked mole rat that lives in the South Africa. And it lives in burs where it's there's low oxygen and it lives because it makes fr dose and the fr dose keeps the oxygen needs down.
 . So when you give fr dose to a tumor cell, they [00:34:00] like it because it stimulates this glycolysis. So there were these beautiful papers in nature. Showing that high fructose corn syrup can stimulate tumor growth. And there's, a lot of data showing that people who are overweight, have an increased risk for tumors and the tumors that they have, the increased risk for like bras, colon, liver are tumors that like fructose.

And , we've gone on and shown that the uric acid that's produced by fruit dose actually plays a role in cancer growth. And we even, raised uric acid. In cell, and showed that it could accelerate tumor growth in animals. So I think the switch is also affecting cancer. It's not like causing cancer , but it's making the cancers grow more rapidly.

So , another hit to sugar, another hit to fruit dose. And then the other thing is. All these things like high salt diets, high sugar diets, obesity, they're all risk factors for dementia [00:35:00] and Alzheimer's disease. Really. No one has

understood it because, it's associated with these things called amyloid and these plaques and, these things called towel protein.

But, when people try to block those things, they, the benefits aren't so strong. So they're looking for what could be causing those problems. . And what they found is that most people with Alzheimer's have a problem, metabolizing glucose, and that there seems to be a mitochondrial problem where the mitochondria is suppressed.
And there seems to be a kind of a shift towards And there seems to be, an insulin resistance in the brain. And guess what does all that. And so guess what, there are now studies showing that fructose levels are high in the brains of Alzheimer's patients. And, so fructose levels are high.

The risk factors are there. There's some studies showing that fruit dose in the brain can cause the insulin resistance, the mitochondrial problems, and even, , affect memory of [00:36:00] animals. So I'm beginning to think that, Alzheimer's disease is another casualty of the switch and that, it was meant to be just like it was meant to, be good.

There was a point where just minimal and transient activation of the switch could help an animal cuz it actually activates things associated with foraging. But these foraging responses involve It, becoming a little insulin resistant in the brain and things like that. And so that could be a beneficial thing, acutely, but chronically, it might actually be a big problem.

And so so I've been, I, say it's, I feel very fortunate Claudia, because, this research led to this, we stumbled onto the switch and then suddenly we realized that this switch is involved in a lot. A lot of disease. And so it gives the opportunity to, both by diet, by, things, simple things like drinking, more water, stimulating mitochondrial, to [00:37:00] grow back with your green tea.

 Or with your dark chocolate does it too. There's like nice things that come out of this where we can help people. And, and then also in the long term, you. Big pharma are now gonna try to make inhibitors of some of these things. I'm my little group is trying to make inhibitors too.

My goal is not to make money. My goal is to help people. That's why I became a doctor and, so if we can find ways to block this switch, it would be a great thing for mankind, or humankind. So anyway, , yeah. Amazing what you're

Claudia von Boeselager: doing. Yeah. And I think it not just about maybe blocking it, but just for sharing the education and your work around the consequences.
So people can make lifestyle choices. So get to the root cause of exactly. Nature wants us to be fats, your wonderful book. And people obviously to read that as well, because if you know what the drivers are and you can adjust your lifestyle accordingly and to realize, with salt as well.

 And for example, my mother who has extreme low blood pressure, [00:38:00] she's told to eat more salt. Very. And so again, it's almost, how do are there cases with low blood pressure where you think it's okay or do you, would you say in general salts should be avoided.

Dr. Richard Johnson: It's a really tough thing.
So let's just talk about that. What if you have, cancer and, and you have no appetite and you're losing weight. Part of me feels that it's probably more important to get food in you kind of food that you could help you and, it may be that, that theoretically fructose could possibly lead to more cancer growth, but if you're not eating at all and that you still could eat a piece of sugar, a chocolate cake, I would give the cake, just to eat some cause it's like the balance, the, we have to look at what the overall goal is.

 If, we really, so if your blood pressure's really low. Eating a high salt diet may help with the blood pressure, but yeah, consequence might be that you might activate the switch. It might hold on. It might [00:39:00] produce a little more. But maybe, but if it makes your blood pressure go up so that you feel better and can walk around, , it seems like a good idea.

 The doctor, , you have to balance, the pros and the cons. Yeah. And the patient should know too. yeah. And then you can decide together. Yeah. But,

Claudia von Boeselager: but it was interesting. We had the, we had the nurse that was there and she said, you could very well be dehydrated, which is the cause of your low blood.

Yes, for sure. And speaking with you now about this as well, it rings true because I think, unfortunately my mother suffers with memory loss due to head trauma. So Dr. Del Breen went through his test and analysis and lack of HRT and she forgets how much she's actually drinking.

Because of the memory. Ah, and, so we have a new system where, she can actually measure how much she's actually drunk in the day because otherwise, one forgets, and just to really be on top of getting the right amount of hydration in it, and then seeing what the knock on effects without having to have that extra sugar in.

Dr. Richard Johnson: Sorry. , you, yeah. And you can measure, so you can measure the serum, [00:40:00] sodium the serum, and everybody probably should know what their serum sodium. So cuz our data shows that if your serum sodium is like 1 45, or higher, the chances of you developing obesity are higher.

And also the chances that your dehydrate need more water are there are higher.
 but a normal serum sodium is like 1 30, 8 to one 40 1 42. So if you're between 1 38 and 1 42. that's really normal  and if it's over 1 42, you should drink more water. And if your, a mom, is dehydrated because she doesn't have enough water then her serum sodium would be over 1 42 would dehydrate.
She should be drinking

Claudia von Boeselager: more water. I'm gonna be checking that. I'm really sorry. I just realized my battery's running low. So one, one second, Rick. I apologize. Yeah.

Dr. Richard Johnson: Okay,

Claudia von Boeselager: so I'm back. welcome back. Thank you very much. Yeah. See, we all need some recharging batteries here, including my my laptop. So Rick, what would be five strategies you would recommend? Especially we were touching on dehydration point and obviously fr dose, but what would be five key takeaways for my audience that you would say, focus on these just to, and check how you feel afterwards.

Dr. Richard Johnson: Yeah. Okay. Just five general recommendations. One is, cut, don't drink sugary beverages and read labels, for sugar is, think about processed food a lot. And so that's number one, number two, , try not to eat a lot of salty foods. And it, and if you can reduce, your salt intake, that would be a positive thing.
 And drink water would be my third recommendation, drink six to eight glasses of water a day, especially drinking water before meals and, a fourth thing might be to,[00:42:00] exercise. 40 minutes to an hour, three times a week and that can help stimulate those, mitochondria to recover and become healthier

And, if you, the way to do it is to walk or, jog or, be on a bicycle, ,and to exercise to the point where you have a little trouble. But you can still communicate and that will put you in the zone too, and that will stimulate those mitochondria. So now you're turning off the switch by reducing sugar and salt.

And at the same time, you're stimulating recovery. You can also stimulate recovery by, the mitochondria with green tea, , like what you're doing, dark chocolate. So that's another thing. And then the fifth one is, , the other major driver of obesity seem to be these high glycemic carbs, bread, rice potatoes,

 These are the main guys chips , and starchy foods and really, , trying to reduce that is gonna be very hard, but it's gonna be very helpful. . So that those would be my [00:43:00] five quick recommendations. I do go into much more detail and in the book and so forth, but that's what I would suggest.

Claudia von Boeselager: Yeah. Nature wants us to be fat, highly recommendable, so well written and so well researched, Rick, thank you so much again for coming on. Today's such a pleasure and we'll have to do a round three with all your new discoveries that are coming through as well.

Dr. Richard Johnson: Thank you, Claudia. Yeah. Thank you so much for bringing me on

Claudia von Boeselager: such a pleasure.

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